No Stigma

Have you ever used substances? If you have, you are the norm. Most people use substances - both licit and illicit - at some point in their lives. And if they don't, they probably love and care about someone who does.

It's useful to remember that every substance provides potential benefits - and potential harms.  We know that substance use carries risks, including the risk of becoming dependent or developing a substance use disorder. Fortunately, substance dependence and substance use disorders (SUDs) can be treated and managed. We have evidence-based medical, behavioral pharmacological, and public health interventions to address them.

Unfortunately, many of the negative consequences we associate with drug use are not so easily addressed. Many of them are the result of the way we think about people who use drugs and the things that we do to punish them.


Many of the health harms we associate with drug use have nothing to do with the substances themselves - but with our responses to their use. As a society, we are the cause of many of the harms. And as a community, we can create helpful solutions.

If you want to improve care for parents, infants, and families affected by drug use and exposure - you will first need to examine your own attitudes and beliefs. Ask yourself: What beliefs have you developed? Are they useful? Are they accurate? Are they helpful? When you ask yourself these questions it becomes easier to understand why we do the things we do and what the consequences of our actions mean.

Ethics Unwrapped: Implicit Bias,

Moral Agent & Subject of Moral Worth,
and Causing Harm
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Stigma Leads to Poor Quality Care

Among the populations of people who use drugs, pregnant women face some of the most severe health and social consequences. Pregnant women who use criminalized drugs are routinely subjected to dehumanizing stigma, insufficient access to evidence-based treatment, and ineffective punitive responses.


Inaccurate media reporting and exaggerated beliefs about harms to drug-exposed infants—such as the myth of the “crack baby”—have intensified this stigma. As a result, the rights of pregnant women who use drugs are rarely considered in the development of drug policies, government-funded social programs, or harm reduction interventions.

Despite these inadequacies, women themselves are routinely blamed and demonized for their drug consumption. This publication serves as a guide for those wishing to implement gender-responsive approaches and policies which are tailored for pregnant women who use drugs. In the development of this publication, the reports from women with personal experiences of drug use during pregnancy was considered as important as the peer-reviewed research and exemplary policy approaches cited.

- from Expecting Better: Improving Health and Rights for Pregnant Women Who Use Drugs,
a publication of the Open Society Foundations
My Daughter’s Birth Exposed the Medical Community’s Anti-Drug Stigma

Olivia arrived through an emergency C-section triggered by Carolyn’s preeclampsia, a prenatal condition involving dangerously high blood pressure. Despite that difficult circumstance, the event should have brought nothing but joy—and joy was, and remains, our overwhelming emotion. But in the weeks after Olivia’s birth, Carolyn and I would learn what it feels like to be thrust under the microscope of suspicion around supposed drug exposure.  - read the article

Stigma Kills

"As a whole, women with substance use disorders do quite well during pregnancy, due in large extent to access to care, insurance coverage and attention from social services," said Mishka Terplan, an obstetrics and gynecology physician at Virginia Commonwealth University School of Medicine. "Where things fall apart is postpartum. We actually abandon women after delivery."

The year after childbirth is the deadliest for addicted women by Christine Vestal, Stateline for the PBS News Hour

Stigma Hurts All of Us
Break the Stigma

What if, instead of seeing labels, we saw people who are struggling and could be there for them so they didn't feel so along?

What if, as a society, we used empowering words and healthy images to help people feel supported?

Maybe then more of us could feel comfortable telling others when we're having a hard time. Maybe more people would get the healthcare they need.

Stigma Robs Us of Our Humanity
Dr. Brené Brown on Empathy and Blame.

Academy of Perinatal Harm Reduction

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Portland, OR  97282

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The information on this site and in our presentations is offered as public health education.

It does not replace getting individualized care with licensed medical professionals.

The purpose of Harm Reduction is not to encourage or condone the use of substances.

Our purpose is to educate patients and providers so they can make informed decisions.


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